Jonathan R. Egan, MBBS, FRACP, FJFICM, Tanya L. Butler, PhD, Andrew D

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Presentation transcript:

Myocardial membrane injury in pediatric cardiac surgery: An animal model Jonathan R. Egan, MBBS, FRACP, FJFICM, Tanya L. Butler, PhD, Andrew D. Cole, BAppSc, Smartin Abraham, MCh, John S. Murala, MCh, David Baines, MBBS, FANCZA, Neil Street, MBBS, FANCZA, Lance Thompson, MBChB, FCA, Oliver Biecker, BSc, John Dittmer, CCP, Sandra Cooper, PhD, Carol G. Au, BSc, Kathryn N. North, MD, David S. Winlaw, MD, FRACS The Journal of Thoracic and Cardiovascular Surgery Volume 137, Issue 5, Pages 1154-1162 (May 2009) DOI: 10.1016/j.jtcvs.2008.10.009 Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Myocardial membrane fraction densitometry. Membrane fractions were measured by Western blot densitometry (controlled for protein loading by α actinin-2 measurement). Lambs are grouped as non CPB-controls (solid bar), CPB−P188 (gray bar), and CPB+P188 (open bar). Protein levels were compared between groups with the Mann–Whitney U test. A, The CPB+P188 group shows higher membrane dystrophin levels than the non-CPB control (∗P < .05) and CPB−P188 (#P < .05), B. The CPB−P188 group shows a significant decrease in dysferlin expression compared with the non-CPB control (∗P < .05). CPB, Cardiopulmonary bypass. The Journal of Thoracic and Cardiovascular Surgery 2009 137, 1154-1162DOI: (10.1016/j.jtcvs.2008.10.009) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Myocardial aquaporin 1 (AQP1) protein expression. Western analysis of total AQP1 protein was normalized to cardiac actin. Lambs are grouped as non-CPB controls (solid bar), CPB−P188 (gray bar), and CPB+P188 (open bar). Protein levels were compared between groups with the Mann–Whitney U test. Representative results demonstrate a significant increase at 9 hours after CPB in the CPB−P188 group compared with non-CPB controls (∗P < .05). CPB, Cardiopulmonary bypass. The Journal of Thoracic and Cardiovascular Surgery 2009 137, 1154-1162DOI: (10.1016/j.jtcvs.2008.10.009) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Measures of colloid osmotic pressure and hemoglobin. Lambs are grouped as CPB−P188 (dashed line) and CPB+P188 (solid line). Comparison between groups was by the Mann–Whitney U test. A, Reduction in colloid osmotic pressure was greater at 9 hours in the CPB–P188 group 3.5 ± 0.46 mm Hg compared with a drop of 1.46 ± 0.58 mm Hg in the CPB+P188 animals (∗P < .05). B, Hemoglobin dropped in the CPB−P188 group after CPB compared with the CPB+P188 animals (∗P < .05). CPB, Cardiopulmonary bypass; COP, colloid osmotic pressure; Hb, hemoglobin; MUF, modified ultrafiltration. The Journal of Thoracic and Cardiovascular Surgery 2009 137, 1154-1162DOI: (10.1016/j.jtcvs.2008.10.009) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Hemodynamic and biochemical variables. Lambs are grouped as CPB−P188 (dashed line) and CPB+P188 (solid line). Comparison between groups was by both the Mann–Whitney U test and linear mixed models using covariance type AR−1 as appropriate. A, Heart rate (HR) was higher in the CPB+P188 group during the later epochs, but overall the difference was not significant. B, Systolic blood pressure (SBP) was significantly higher in the CPB+P188 group during the later epochs, but overall not different, C and D, Mean blood pressure (MBP) and diastolic blood pressure (DBP), respectively. Both are significantly higher overall in the CPB+P188 group (∗P < .01). E, Lower lactate in the CPB+P188 group after reperfusion (∗P < .05), but similar levels subsequently. F, The change in venous saturation after CPB compared with baseline was significantly higher in the CPB+P188 group at 6 and 9 hours after CPB, with a final increase of 10% ± 7% compared with a drop in the CPB−P188 group of 9% ± 3% (∗P = .05). The Journal of Thoracic and Cardiovascular Surgery 2009 137, 1154-1162DOI: (10.1016/j.jtcvs.2008.10.009) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions